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As a home health nurse, what choice do I have when a patient requests that I ask his son to leave and to call 911 if he refuses?

Monday October 22, 2012
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Dear Nancy,

I am a home healthcare nurse. My patient has asked that if his son comes over, I should ask him to leave and call 911 if he refuses. I really don't want to get into a family conflict and advised my patient to file a restraining order, but he refused. If the son becomes violent, then I will ask him to leave or call 911. What other choice do I have?


Nancy Brent replies:

Dear Lillian,

This situation sounds like a disaster waiting to happen. Not only is the patient at risk, but you may be as well. Since your suggestion of the patient filing a restraining order against the son has been rejected (this is often the case because of family dynamics, lack of financial resources, etc.), you need to get input immediately from your nurse supervisor at the agency. You should not get personally involved in this family's conflict.

A care conference (or whatever term it is called at your agency) should take place with you, any aides involved in the care of this patient, a psychiatric/mental health nurse consultant or other mental health consultant and the physician. It may be that some intervention can occur that reduces the risk to the two of you in the home. Or, the agency may decide you and other employees should not be providing care to this patient, as sad as that may be, if the risk is too high. A third alternative is that you take an escort into the home, either another employee (male, if possible) or someone else identified by the agency.

The agency may want to reach out for suggestions and help from a local agency, specifically working with the legal and safety issues of elders in the home and a specific emphasis on elder protection. That agency may, for example, have group or other support for the family members who have ill parents in the home, in addition to help for the elderly individual.


Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.